目前在学术外科手术中使用国家外科质量改进计划的外科风险计算器:一种混合方法研究
Samuel M Miller1,2, Sara Abou Azar1, James S Farrelly3
1Department of Surgery, Yale School of Medicine, United States.
Surgery in practice and science
|July 28, 2023
概括
大多数外科医生使用NSQIP手术风险计算器 (NSRC),但很少. 障碍包括感知精度和工作流程集成,建议改善教育和电子健康记录集成,以增加其在外科决策中的使用.
科学领域:
- 手术结果研究研究.
- 医疗信息学 医疗信息学
- 临床决策支持 临床决策支持
背景情况:
- NSQIP手术风险计算器 (NSRC) 是一个旨在预测手术结果的工具.
- 了解目前的采用率和NSRC使用障碍对于优化其影响至关重要.
研究的目的:
- 量化评估NSRC在当前手术实践中的使用情况.
- 确定阻碍NSRC采用障碍的障碍,并探索潜在的干预措施,以加强其使用.
主要方法:
- 进行了一项横截面研究,涉及七个机构的外科医生.
- 数据收集的重点是临床实践中自报告的NSRC应用,具体的场景和感知到的障碍.
主要成果:
- 在99名接受调查的外科医生中,73.7%报告说最近使用了NSRC,但超过一半的人很少使用它 (<20%的手术前讨论).
- 在非选择性病例和老年,功能依赖或代孕同意的患者中,NSRC的使用率更高.
- 障碍包括对外科决定缺乏影响和对计算器准确性的担忧.
结论:
- 虽然许多外科医生使用NSRC,但频繁应用是有限的,特别是在高风险患者.
- 外科医生建议加强工作流集成和改善教育,以增加NSRC的实用性.
- 解决准确性问题和优化EHR集成是更广泛采用的关键策略.
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